Variations in Performance of Mental Health Providers in the English NHS: An Analysis of the Relationship Between Readmission Rates and Length-of-Stay.
Moran, Valerie;
Jacobs, Rowena;
Mason, Anne;
(2016)
Variations in Performance of Mental Health Providers in the English NHS: An Analysis of the Relationship Between Readmission Rates and Length-of-Stay.
Administration and policy in mental health, 44 (2).
pp. 188-200.
ISSN 0894-587X
DOI: https://doi.org/10.1007/s10488-015-0711-4
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
Length-of-stay (LOS) for inpatient mental health care is a major driver of variation in resource use internationally. We explore determinants of LOS in England, focusing on the impact of emergency readmission rates which can serve as a measure of the quality of care. Data for 2009/2010 and 2010/2011 are analysed using hierarchical and non-hierarchical models. Unexplained residual variation among providers is quantified using Empirical Bayes techniques. Diagnostic, treatment and patient-level demographic variables are key drivers of LOS. Higher emergency readmission rates are associated with shorter LOS. Ranking providers by residual variation reveals significant differences, suggesting some providers can improve performance.